This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The primary study objective is to compare the efficacy of lithium in combination with riluzole to riluzole in combination with placebo in volunteers with ALS. Primary efficacy will be assessed by analyzing disease progression as measured by a 6-point drop in the ALS Functional Rating Scale - Revised (ALSFRS-R) from baseline value or death.